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Medicare pays for the CA 19-9 blood test to follow people already diagnosed with pancreatic or bile duct cancer, not to diagnose them.
United States, Medicare laboratory National Coverage Determination 190.30, version 1, effective 25 November 2002. The NCD says CA 19-9 levels "are useful in following the course of patients with established diagnosis of pancreatic and biliary ductal carcinoma. The test is not indicated for diagnosing these two diseases." It is not covered for evaluating patients with signs or symptoms suggestive of malignancy, and may be ordered as needed to assess recurrence or response to subsequent treatment cycles. CMS publishes quarterly lists of covered diagnosis codes; the latest listed is October 2026.
Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
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Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
Shares Centers for Medicare & Medicaid Services (CMS) and the tag us.
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